Impact of Implementing a Novel Anti Tuberculosis Treatment Stewardship Program from a Tertiary Care Centre, Kerala, India

Kunoor, Akhilesh; Prabhu, Binny; Menon, Vidya; Kumar, Aman; Shameen, Fathima; Joseph, Mariam Varsha; Rakesh, P S; Singh, Sanjeev

doi:10.2139/ssrn.3797584

Cited by 1 publication

(1 citation statement)

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“…Most clinical pharmacy service studies did not always follow the consistent characterization of their components, which means that the content or terminology describing the detailed activities of the services tends to vary across different studies (Bonetti et al, 2020). However, as a part of broader multidisciplinary services, pharmacists' actions through clinical pharmacy services have a noticeable benefit, for example, in curbing microbial resistance (Padayatchi et al, 2016;Kunoor et al, 2021), especially in TB care. Using the DEPICT (Correr et al, 2013), we characterized the components of clinical pharmacy services and their outcomes in TB care.…”

Section: Discussionmentioning

confidence: 99%

Clinical pharmacy services for tuberculosis management: a systematic review

et al. 2023

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Objective: This study aims to systematically review the content and potential effects of clinical pharmacy services in tuberculosis (TB) care management.Methods: Searches were performed in PubMed, Embase, Cochrane, Scopus, and Web of Science databases following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Study characteristics and outcomes were extracted, and clinical pharmacy service components were characterized using the Descriptive Elements of Pharmacist Intervention Characterization Tool.Results: Twenty articles were included for full-text assessment, of which 10 fulfilled inclusion criteria, comprising 1,168 patients (N = 39 to 258 per study). These articles included five prospective cohort studies, two case–control studies, two quasi-experimental studies, and one cross-sectional study. Intervention foci within clinical pharmacy services were medication adherence (50%), medication safety (40%), education to patients/caregivers regarding needs/beliefs (30%), optimizing medication/therapy effectiveness (30%), emphasizing HRQoL (10%), and drug selections (10%). The three most frequently applied interventions were drug information/patient counseling (80%), adverse drug reaction monitoring (50%), and drug use evaluation (20%). Based on the World Health Organization (WHO) outcome classification, treatment success ranged from 72% to 93%, with higher cure outcomes (53%–86%) than treatment completion (7%–19%). Other outcomes, including isoniazid metabolites, medication counts, sputum conversion, adherence/compliance, knowledge, and quality of life, were better in the intervention group than those in comparator groups, and/or they improved over time. Risk of bias analysis indicated that the included studies were not comparable to a randomized clinical trial.Conclusion: Clinical pharmacy services as single or composite interventions potentially improve TB outcomes, but its evidence is still inconsistent and limited due to the lack of randomized controlled studies using the WHO outcome classification.Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199028, identifier CRD42020199028.

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